EP0516582A1 - Dispositif de ponction des vaisseaux sanguins - Google Patents

Dispositif de ponction des vaisseaux sanguins Download PDF

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Publication number
EP0516582A1
EP0516582A1 EP92810313A EP92810313A EP0516582A1 EP 0516582 A1 EP0516582 A1 EP 0516582A1 EP 92810313 A EP92810313 A EP 92810313A EP 92810313 A EP92810313 A EP 92810313A EP 0516582 A1 EP0516582 A1 EP 0516582A1
Authority
EP
European Patent Office
Prior art keywords
probe
puncturing device
needle
coupling piece
sterile
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
EP92810313A
Other languages
German (de)
English (en)
Inventor
Eric Dr. Med. Dardel
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Sulzer Medizinaltechnik AG
Original Assignee
Sulzer Medizinaltechnik AG
Sulzer AG
Gebrueder Sulzer AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Sulzer Medizinaltechnik AG, Sulzer AG, Gebrueder Sulzer AG filed Critical Sulzer Medizinaltechnik AG
Publication of EP0516582A1 publication Critical patent/EP0516582A1/fr
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4422—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to hygiene or sterilisation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00142—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with means for preventing contamination, e.g. by using a sanitary sheath
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • A61B8/0841—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • A61B2017/3413—Needle locating or guiding means guided by ultrasound
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4887—Locating particular structures in or on the body
    • A61B5/489—Blood vessels

Definitions

  • the invention relates to puncturing devices for blood vessels according to the preamble of claim 1 and sterile sheaths for such puncturing devices.
  • the ultrasound probe of such a device has a transmitter / receiver arrangement with which ultrasound can be radiated into the body and a signal of the partially reflected beam can be registered. Thanks to the Doppler effect, reflection on the flowing blood results in a frequency shift from which an acoustic and / or optical signal can be obtained. The puncture point for the puncturing needle can be found by searching for a maximum of such a signal.
  • the transmitter / receiver arrangement has a construction in which a guide channel for the needle runs through the sound transducer.
  • This construction is disadvantageous because the puncturing must be carried out under sterile conditions and because a necessary gas sterilization of the ultrasound probe is very time-consuming.
  • sterility can be achieved by means of a sterile sleeve intended for single use (see for example EP-A 0 104 618). With these simpler probes, however The needle should not be guided coaxially to the emitted ultrasound beam.
  • a coupling piece which directs the ultrasound under reflection on a mirror surface into the body and in which the needle guide channel is arranged, is made of sterile or sterilizable material. This coupling piece can be part of the sterile sheath; but it can also be provided as an additional piece that can be placed on the cover.
  • the sterile sleeve with the coupling piece is preferably intended for single use.
  • the case In the case of a compact puncturing device that can be held in the hand, the case is designed in such a way that the device is completely enclosed.
  • the optical and / or acoustic display means are accommodated in a stationary device part which is set up separately, it is sufficient if only the puncturing device in the treatment area (ie probe and possibly part of the connecting cable) is sheathed in a sterile manner .
  • the coupling piece can be made of a solid material that conducts ultrasound well, the ultrasound mirror being formed, for example, by a free outer surface which is arranged in accordance with the sound optics.
  • the coupling piece can also consist of a housing which is filled with an ultrasound-conductive gel, wherein the mirror can consist, for example, of a metallic body which simultaneously forms part of the housing wall and the needle guide channel.
  • the coupling piece 1 with the housing 11, is injection molded from plastic, for example, the ultrasound mirror 12 (or reflector for the ultrasound beam), which consists of a flat metal plate, and the needle guide channel 13, which passes through the mirror in the central region; also the ultrasound probe 20, which is connected to a stationary part of the puncturing device, not shown, via the cable 21.
  • the ultrasound mirror 12 or reflector for the ultrasound beam
  • the needle guide channel 13 which passes through the mirror in the central region
  • the ultrasound probe 20 which is connected to a stationary part of the puncturing device, not shown, via the cable 21.
  • the ultrasound probe 20 emits an ultrasound beam (symbolized by the two arrows U) into the cavity 15 filled by a coupling gel (not shown), the beam being reflected at the mirror 12 to the outlet opening 15a.
  • the outlet opening 15a is circular in the present first exemplary embodiment, and the ultrasound beam emerges perpendicular to this opening.
  • the needle guide channel 13 is accordingly also oriented perpendicular to the outlet opening 15a.
  • the probe 20 can be inserted into the housing 11.
  • the probe 20 is advantageously designed in such a way that the connecting cable 21 with a plug 21a and a cover plate 21b can be plugged onto the probe head.
  • This connecting cable 21 and the coupling piece 1 are packaged in a sterile state and unpacked only immediately before the treatment and plugged together with the ultrasound probe 20 to form a ready-to-use, sterile puncturing device. Suitable measures must of course be taken, for example by using sterile forceps, to ensure that the non-sterile probe 20 does not contaminate the outer surfaces of the coupling piece 1 and the cover plate 21b, which form the sterile probe cover.
  • a ventilation channel for example a bore or groove in the housing wall 11 (not shown), is advantageously provided.
  • the ultrasound probe 20 is rod-shaped, and the coupling piece 1 guides the ultrasound waves (symbolized by circular arcs W) at an acute angle A through the elliptical outlet opening 15a.
  • the outlet opening 15a can be placed flush on the body surface (indicated by the dash-dotted line 51).
  • the needle 30, which is attached to a syringe 31, is pushed into this blood vessel 50 along the convergent ultrasound beam (focus F) - after locating the blood vessel 50 by means of the Doppler effect.
  • the coupling gel 16 is indicated, with which the cavity 15 ( Figure 3) is filled.
  • the ultrasound mirror 12 of the second exemplary embodiment is formed by an obliquely cut circular cylinder, which is made of steel, for example.
  • the longitudinal bore 13 serving as a needle guide can run centrally or somewhat eccentrically.
  • At the mouth 14 of the channel 13, its cross section is expanded in such a way that it fits positively, for example, on a square 32, which is provided at the rear end of the needle 30 and has the following purpose: after the blood vessel 50 has been punctured, the syringe 31 must be removed from the Needle 30 are removed. For this purpose, the probe 20 with the coupling piece 1 is moved backwards along the fixed needle 30 and the square 32 is inserted into the channel opening 32.
  • the syringe 31 can now be removed from the needle with the other hand; a Thanks to the square 32, the needle 30 is prevented from rotating as well.
  • other means can also be selected by means of which the needle 30 can also be blocked from rotating.
  • the sterile coupling piece 1 is placed on the rod-shaped ultrasound probe, the area of the probe not covered by the coupling piece having previously been sheathed, for example, with a sterile sleeve or a sterile latex tube.
  • a wound hose 111 made of an elastomeric material can also be arranged on the coupling piece 1, as shown in FIG. This coupling piece 1 is plugged onto the non-sterile probe, and the hose 111 can then be unwound onto the probe.
  • a part of the connecting cable 21 can also be encased with the hose 111, which in this case therefore need not be sterile.
  • the ultrasound mirror 12 can be made from a dense material such as metal or glass.
  • FIG. 4 shows an embodiment in which the ultrasound mirror is formed by a membrane 120 which is stretched out in front of a cavity 121.
  • the ultrasound that propagates in the gel-filled cavity 15 and in the membrane 120 is reflected at the interface 120a between the membrane 120 and the cavity 121.
  • the wall piece 122 forms the frame over which the membrane 120 is held stretched. No reflection of the ultrasound takes place at the point of passage of the needle guide channel 13 through the membrane 120. Therefore, the channel wall 125 is advantageously made thin in the vicinity of the membrane 120.
  • the fourth exemplary embodiment is a compact puncturing device 2 which is battery-operated and which has acoustic and optical display means, for example a loudspeaker 25 and a chain of light-emitting diodes 26, with which the on the Doppler effect based signals can be displayed. Furthermore, this device has operating buttons 27 with which the device can be switched on or off and, for example, the volume can be regulated.
  • the puncturing device 2 consists on the one hand of the non-sterile device part 2 'with the ultrasound probe 20, the display means 25 and 26 and the control buttons 27 and on the other hand from the sterile sleeve according to the invention, which is composed of the lower shell 17 and the upper shell 18 with the coupling piece 1 .
  • the cover is designed in such a way that there is a good sound-radiating coupling between the loudspeaker 25 and the cover wall 17a and that the cover wall 18a is flexible with the operating buttons 27 so that these buttons can be pressed.
  • the envelope In order for the visual display 26 to be visible, the envelope must be made of a transparent material.
  • the coupling piece 1 in the fourth embodiment is similar to that in the second (FIG. 3); other embodiments are of course also possible here.
  • 5b shows further features of the coupling piece 1, which can also be realized in the other examples:
  • the coupling piece 1 is closed on the body side by a membrane 112 made of elastomeric material and the coupling gel 16 is separated from the probe 20 by a membrane 113. Due to the convex shape of the flexible membrane 112, the coupling piece 1 can be snugly applied to the body surface.
  • the needle guide channel 13 can also be closed with a pierceable membrane (not ) to prevent gel 16 from escaping from cavity 15.
  • the membrane 113 which can be very thin, must lie tightly on the radiation surface of the ultrasound probe 20 in order to keep losses during sound transmission at this interface as low as possible.
  • the coupling piece 1 of the fourth exemplary embodiment can be regarded as an additional piece of the sterile sleeve, which is formed from the two shell parts 17 and 18.
  • FIG. 1 Another example of a coupling piece 1 designed as an additional piece is shown in FIG.
  • This coupling piece 1 is placed on a probe 20 which has previously been covered with a sterile, bag-like tube made of an elastomeric material.
  • the coupling piece 1 consists of the mirror 12, the needle guide 13 '(with the needle guide channel 13), the clasp 130, which has, for example, a groove 131, and the connecting piece 132.
  • the space between the probe 20, mirror 12 and the body surface must of course again with Coupling gel 16 may be filled. This requirement can be met in a practical manner with a "balloon" 115 filled with gel and enveloping the coupling piece 1, as shown in FIG. 6b.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Veterinary Medicine (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Molecular Biology (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biophysics (AREA)
  • Physics & Mathematics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Optics & Photonics (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)
EP92810313A 1991-05-27 1992-04-29 Dispositif de ponction des vaisseaux sanguins Ceased EP0516582A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CH1561/91 1991-05-27
CH156191 1991-05-27

Publications (1)

Publication Number Publication Date
EP0516582A1 true EP0516582A1 (fr) 1992-12-02

Family

ID=4213298

Family Applications (1)

Application Number Title Priority Date Filing Date
EP92810313A Ceased EP0516582A1 (fr) 1991-05-27 1992-04-29 Dispositif de ponction des vaisseaux sanguins

Country Status (5)

Country Link
US (1) US5261409A (fr)
EP (1) EP0516582A1 (fr)
JP (1) JPH05168636A (fr)
CN (1) CN1066972A (fr)
RU (1) RU2050153C1 (fr)

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1993016640A1 (fr) * 1992-02-27 1993-09-02 Epimed Ag Dispositif de guidage d'un dispositif de ponction et son utilisation a l'aide d'un appareil manuel pour reperer des vaisseaux sanguins
WO1994015532A2 (fr) * 1993-01-18 1994-07-21 Eric Dardel Procede permettant de localiser et de ponctionner des vaisseaux sanguins
WO1994022373A1 (fr) * 1993-04-01 1994-10-13 Armin Bollinger Piece d'accouplement utilisee comme element de transmission pour une sonde doppler ultrasonique
EP0712294A1 (fr) * 1993-08-05 1996-05-22 Cardiovascular Dynamics, Inc. Systeme d'acces au reseau vasculaire a cable coaxial
WO2000024317A1 (fr) 1998-10-26 2000-05-04 Universitätsklinikum Charite Medizinische Fakultät Der Humboldt-Universität Zu Berlin Systeme pour ponctionner des vaisseaux
WO2016177463A1 (fr) * 2015-05-03 2016-11-10 Isys Medizintechnik Gmbh Dispositif de positionnement d'instruments stériles

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CA3135000A1 (fr) 2019-05-01 2020-11-05 Bard Access Systems, Inc. Dispositifs de ponction, systemes de ponction comprenant ces dispositifs de ponction, et procedes associes
EP4017372A4 (fr) * 2019-08-23 2023-08-16 Medulla Pro Technology Pte. Ltd. Appareil, système et procédé pour faciliter l'imagerie médicale à ultrasons
CN112120765A (zh) * 2020-09-25 2020-12-25 新乡医学院第一附属医院 一种心血管科用动脉造影穿刺装置

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WO1984003034A1 (fr) * 1983-02-07 1984-08-16 Herbert Renald Christian Drue Cellule a fixation verticale pour une tete de scanner ultrasonore
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WO1993016640A1 (fr) * 1992-02-27 1993-09-02 Epimed Ag Dispositif de guidage d'un dispositif de ponction et son utilisation a l'aide d'un appareil manuel pour reperer des vaisseaux sanguins
WO1994015532A2 (fr) * 1993-01-18 1994-07-21 Eric Dardel Procede permettant de localiser et de ponctionner des vaisseaux sanguins
WO1994015532A3 (fr) * 1993-01-18 1994-09-01 Eric Dardel Procede permettant de localiser et de ponctionner des vaisseaux sanguins
AU672668B2 (en) * 1993-01-18 1996-10-10 Eric Dardel Blood vessel locating and puncturing device
WO1994022373A1 (fr) * 1993-04-01 1994-10-13 Armin Bollinger Piece d'accouplement utilisee comme element de transmission pour une sonde doppler ultrasonique
EP0712294A1 (fr) * 1993-08-05 1996-05-22 Cardiovascular Dynamics, Inc. Systeme d'acces au reseau vasculaire a cable coaxial
EP0712294A4 (fr) * 1993-08-05 1996-10-16 Cardiovascular Dynamics Inc Systeme d'acces au reseau vasculaire a cable coaxial
WO2000024317A1 (fr) 1998-10-26 2000-05-04 Universitätsklinikum Charite Medizinische Fakultät Der Humboldt-Universität Zu Berlin Systeme pour ponctionner des vaisseaux
WO2016177463A1 (fr) * 2015-05-03 2016-11-10 Isys Medizintechnik Gmbh Dispositif de positionnement d'instruments stériles
US10966793B2 (en) 2015-05-03 2021-04-06 Isys Medizintechnik Gmbh Device for positioning sterile instruments

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CN1066972A (zh) 1992-12-16
JPH05168636A (ja) 1993-07-02
RU2050153C1 (ru) 1995-12-20
US5261409A (en) 1993-11-16

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